NPI | 1215389127 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 6868) |
Additional Taxonomies | 101Y00000X Counselor |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC 6376) | |
101YM0800X Counselor, Mental Health (Licence: SC 6376) | |
Enumeration Date | 2016-07-05 |
Last Update Date | 2018-05-25 |